HF 42

2nd Engrossment - 86th Legislature (2009 - 2010) Posted on 02/09/2010 01:33am

A bill for an act
relating to health; providing continuation coverage under the federal stimulus
act; providing guaranteed issue in the individual insurance market under certain
circumstances; providing state subsidy for COBRA premiums; providing
temporary MinnesotaCare coverage for unemployed individuals; appropriating
money; amending Minnesota Statutes 2008, sections 62A.17, by adding a
subdivision; 62A.65, subdivision 5; 256L.07, by adding a subdivision; proposing
coding for new law in Minnesota Statutes, chapter 256.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2008, section 62A.17, is amended by adding a
subdivision to read:

new text begin Subd. 5a. new text end

new text begin Limited extension of continuation election period. new text end

new text begin (a) An individual
who did not have an election of continuation coverage under subdivision 1 in effect on
February 17, 2009, but who would be an assistance eligible individual as defined in
section 3001(a)(3) of the American Recovery and Reinvestment Act of 2009, if such an
election were in effect, may elect the continuation coverage during the period beginning
February 17, 2009, and ending 60 days after the date on which a notification which meets
the notice requirements of the American Recovery and Reinvestment Act of 2009 is
provided to the individual.
new text end

new text begin (b) Any continuation coverage elected during the extended election period in
paragraph (a) shall:
new text end

new text begin (1) commence with the first period of coverage beginning on or after February
17, 2009; and
new text end

new text begin (2) not extend beyond 18 months from the earliest date continuation could have been
effective if the coverage had been elected when the individual was initially eligible for
continuation coverage under this section.
new text end

new text begin (c) With respect to an assistance eligible individual who elects continuation coverage
under paragraph (a), the period:
new text end

new text begin (1) beginning on the date of the qualifying event; and
new text end

new text begin (2) ending with the beginning of the period described in paragraph (b), clause (1),
shall be disregarded for purposes of determining the 63-day periods referred to in section
701(c)(2) of the Employee Retirement Income Security Act of 1974, section 9801(c)(2) of
the Internal Revenue Code of 1986, and section 2701(c)(2) of the Public Health Service
Act.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment
and expires on June 30, 2010.
new text end

Sec. 2.

Minnesota Statutes 2008, section 62A.65, subdivision 5, is amended to read:

Subd. 5.

Portability and conversion of coverage.

(a) No individual health plan
may be offered, sold, issued, or with respect to children age 18 or under renewed, to a
Minnesota resident that contains a preexisting condition limitation, preexisting condition
exclusion, or exclusionary rider, unless the limitation or exclusion is permitted under this
subdivision and under chapter 62L, provided that, except for children age 18 or under,
underwriting restrictions may be retained on individual contracts that are issued without
evidence of insurability as a replacement for prior individual coverage that was sold
before May 17, 1993. The individual may be subjected to an 18-month preexisting
condition limitation, unless the individual has maintained continuous coverage as defined
in section 62L.02. The individual must not be subjected to an exclusionary rider. An
individual who has maintained continuous coverage may be subjected to a onetime
preexisting condition limitation of up to 12 months, with credit for time covered under
qualifying coverage as defined in section 62L.02, at the time that the individual first is
covered under an individual health plan by any health carrier. Credit must be given for
all qualifying coverage with respect to all preexisting conditions, regardless of whether
the conditions were preexisting with respect to any previous qualifying coverage. The
individual must not be subjected to an exclusionary rider. Thereafter, the individual must
not be subject to any preexisting condition limitation, preexisting condition exclusion,
or exclusionary rider under an individual health plan by any health carrier, except an
unexpired portion of a limitation under prior coverage, so long as the individual maintains
continuous coverage as defined in section 62L.02.

(b) A health carrier must offer an individual health plan to any individual previously
covered under a group health plan issued by that health carrier, regardless of the size of
the group, so long as the individual maintained continuous coverage as defined in section
62L.02. If the individual has available any continuation coverage provided under sections
62A.146; 62A.148; 62A.17, subdivisions 1 and 2; 62A.20; 62A.21; 62C.142; 62D.101; or
62D.105, or continuation coverage provided under federal law, the health carrier need not
offer coverage under this paragraph until the individual has exhausted the continuation
coverage. The offer must not be subject to underwriting, except as permitted under this
paragraph. A health plan issued under this paragraph must be a qualified plan as defined
in section 62E.02 and must not contain any preexisting condition limitation, preexisting
condition exclusion, or exclusionary rider, except for any unexpired limitation or
exclusion under the previous coverage. The individual health plan must cover pregnancy
on the same basis as any other covered illness under the individual health plan. The offer
of coverage by the health carrier must inform the individual that the coverage, including
what is covered and the health care providers from whom covered care may be obtained,
may not be the same as the individual's coverage under the group health plan. The offer
of coverage by the health carrier must also inform the individual that the individual, if
a Minnesota resident, may be eligible to obtain coverage from (i) other private sources
of health coverage, or (ii) the Minnesota Comprehensive Health Association, without a
preexisting condition limitation, and must provide the telephone number used by that
association for enrollment purposes. The initial premium rate for the individual health
plan must comply with subdivision 3. The premium rate upon renewal must comply with
subdivision 2. In no event shall the premium rate exceed 100 percent of the premium
charged for comparable individual coverage by the Minnesota Comprehensive Health
Association, and the premium rate must be less than that amount if necessary to otherwise
comply with this section. An individual health plan offered under this paragraph to a
person satisfies the health carrier's obligation to offer conversion coverage under section
62E.16, with respect to that person. Coverage issued under this paragraph must provide
that it cannot be canceled or nonrenewed as a result of the health carrier's subsequent
decision to leave the individual, small employer, or other group market. Section 72A.20,
subdivision 28, applies to this paragraph.

new text begin (c) A health carrier must offer, sell, issue, and renew an individual health plan on a
guaranteed issue basis, without any preexisting condition limitation, to individuals and
their family members who exhaust temporary MinnesotaCare coverage for unemployed
individuals under section 256L.07, subdivision 8, who are not eligible for regular
MinnesotaCare coverage as determined by the commissioner of human services, and who
apply for coverage from the health carrier within 63 days after denial of eligibility for
regular MinnesotaCare coverage. Guaranteed issue coverage under this paragraph must be
retroactive to the date of denial of eligibility for regular MinnesotaCare coverage. For
purposes of this paragraph, "guaranteed issue" means that a health carrier shall not decline
to cover under a health plan any individual or eligible dependent, including persons
who become eligible dependents after issuance of the health plan. For purposes of this
paragraph, "family" has the meaning provided in section 256L.07, subdivision 8. This
paragraph expires July 1, 2011.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009, and applies to health
plans offered, sold, issued, or renewed on or after that date.
new text end

Sec. 3.

new text begin [256.0122] STATE SUBSIDY FOR COBRA PREMIUMS.
new text end

new text begin The commissioner of human services shall provide to each assistance eligible
individual who is eligible for premium assistance for COBRA benefits under the American
Recovery and Reinvestment Act of 2009 (ARRA), title III, section 3001, with a state
premium subsidy equal to an additional 25 percent of the total premium for COBRA
continuation coverage. The assistance eligible individual's share of 35 percent of the
premium for continuation coverage shall be proportionately reduced. The commissioner
shall pay the state premium subsidy to the entity to whom the assistance eligible individual
is required to pay COBRA premiums, on or before the dates the assistance eligible
individual's COBRA premiums are due. The state premium subsidy must be paid for the
period during which an assistance eligible individual receives the 65 percent premium
subsidy under the ARRA. Employers subject to federal or state continuation law must
provide assistance eligible individuals with notice of the additional state subsidy, in
addition to any other notice required under the ARRA. This section expires December
31, 2010.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from February 17, 2009.
new text end

Sec. 4.

Minnesota Statutes 2008, section 256L.07, is amended by adding a subdivision
to read:

new text begin Subd. 8. new text end

new text begin Temporary MinnesotaCare coverage for unemployed individuals. new text end

new text begin (a)
An individual is eligible for temporary MinnesotaCare coverage under this subdivision if
the individual:
new text end

new text begin (1) is involuntarily unemployed, but not for cause, and had been employed for at
least 18 consecutive months prior to the loss of employment;
new text end

new text begin (2) is not eligible for continuation coverage as described by the Consolidated
Omnibus Budget Reconciliation Act of 1985 (COBRA), Public Law 99-272, as amended,
or state continuation coverage under sections 62A.146, 62A.148, 62A.17, 62A.20,
62A.21, 62D.101, and 62D.105, and similar laws of other states under which a Minnesota
resident is eligible;
new text end

new text begin (3) has gross individual or family income that does not exceed 275 percent of the
federal poverty guidelines; and
new text end

new text begin (4) does not have available to them health coverage through Medicare or
employer-subsidized coverage through a spouse. For purposes of this clause,
"employer-subsidized coverage" means health coverage for which the employer pays at
least 50 percent of the cost of coverage for the employee or dependent.
new text end

new text begin (b) Members of the individual's family are also eligible for MinnesotaCare under
this subdivision. For purposes of this subdivision, "family" has the meaning provided
in Minnesota Rules, part 9506.0010, subpart 11, but also includes any individual who
had been covered under health coverage provided by the most recent employer of the
individual applying for temporary MinnesotaCare coverage.
new text end

new text begin (c) Individuals and family members eligible under this subdivision are exempt from
subdivisions 2 and 3; and section 256L.17. All other requirements of this chapter apply.
new text end

new text begin (d) The commissioner of employment and economic development shall provide
all individuals who make application for unemployment benefits under chapter 268, a
Minnesota emergency unemployment compensation program, or a federal emergency
compensation program, with written notice that the individual and family members
may be eligible under this subdivision for temporary MinnesotaCare coverage, and an
application for this coverage. This information must be provided by the commissioner of
employment and economic development at the same time that information about eligibility
for unemployment benefits is provided.
new text end

new text begin (e) Individuals and family members shall submit applications for temporary
MinnesotaCare coverage to the commissioner of human services. The commissioner
of human services shall determine eligibility for persons seeking coverage under this
subdivision, using the procedures specified in this chapter, unless otherwise provided
in this subdivision.
new text end

new text begin (f) Individuals eligible under this subdivision shall receive coverage for the health
services provided under section 256L.03 to nonpregnant adults with children, except
that the annual limit on inpatient hospital services in section 256L.03, subdivision 3,
shall not apply.
new text end

new text begin (g) Individuals eligible under this subdivision shall receive coverage on a
fee-for-service basis with state-only funds, and are exempt from managed care enrollment
under section 256L.12. The commissioner of human services shall seek federal approval
for matching funds within 30 days of the effective date of this subdivision.
new text end

new text begin (h) Individuals eligible under this subdivision shall pay premiums as determined
under section 256L.15. These individuals are subject to the cost-sharing requirements
specified in section 256L.03, subdivision 5, except that the ten percent coinsurance
requirement for inpatient hospital services shall not apply. Individuals eligible under this
subdivision are exempt from disenrollment for failure to pay premiums.
new text end

new text begin (i) Individuals and family members are eligible under this subdivision for 145 days
of coverage, regardless of whether the eligibility criteria under paragraph (a) continue to
be met after the initial determination of eligibility.
new text end

new text begin (j) Coverage under this subdivision is secondary to a plan of insurance or benefit
program under which an individual or family member has coverage, and the commissioner
of human services shall apply the procedures in section 256L.05, subdivision 3, paragraph
(d). To be eligible under this subdivision, individuals and family members must comply
with section 256L.04, subdivision 2.
new text end

new text begin (k) Individuals and family members who are no longer eligible under this
subdivision may reapply for MinnesotaCare. The commissioner of human services shall
provide individuals covered under this subdivision with reapplication materials no later
than 115 days from the effective date of coverage. All eligibility, premium payment,
and other requirements of this chapter shall apply at the time of reapplication. The
effective date of coverage for persons reapplying shall be the day following the last day
of coverage under this subdivision, for persons who have submitted a written request for
retroactive MinnesotaCare coverage with a completed application within 30 days of the
loss of eligibility. The applicant must provide all required verifications within 30 days of
the written request for verification. For all other persons, the effective date of coverage is
the day specified in section 256L.05, subdivision 3. Individuals denied MinnesotaCare
coverage upon reapplication are eligible to purchase private sector individual health
coverage on a guaranteed issue basis, as provided in section 62A.65, subdivision 5,
paragraph (c), and health carriers as defined in that section must accept applicants and
issue coverage on that basis.
new text end

new text begin (l) This subdivision expires July 1, 2011.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 5. new text begin APPROPRIATION.
new text end

new text begin (a) $....... is appropriated from the health care access fund to the commissioner
of human services for the biennium beginning July 1, 2009, to implement Minnesota
Statutes, section 256L.07, subdivision 8.
new text end

new text begin (b) $....... is appropriated from the health care access fund to the commissioner
of human services for the biennium beginning July 1, 2009, to implement Minnesota
Statutes, section 256.0122.
new text end